Ever since Brittany Maynard chose to take a fatal dose of barbiturates – a dose prescribed by her doctor and sanctioned by the state of Oregon – the emotional debate over physician-assisted suicide and whether patients should have the right to choose the timing of their death has spread to more and more states throughout the United States.
In the just over three months since Ms. Maynard’s internationally-publicized death in November, at least four states – including two of the nation’s most influential and populous, New York and California – have introduced legislation that would legalize assisted suicide. American society as a whole is grappling with the public momentum her case began, addressing the ethics of what advocates call “death with dignity” and opponents fear will stigmatize those who most need humane care.
On Wednesday, a group of physicians and terminally ill patients filed suit in the Supreme Court of Manhattan, challenging the interpretation of a state manslaughter statute that includes anyone “who intentionally causes or aids another person to commit suicide.”
The plaintiffs argue the statute’s scope was never intended to cover doctors who prescribe a lethal dose of drugs at the request of a mentally competent patient. The legal tactic echoes advocates’ preferred use of the term “aid-in-dying” rather than “assisted suicide.”
“For some dying patients, they find themselves trapped in a dying process they find unbearable,” said Kathryn Tucker, one of the plaintiffs’ attorneys at a news conference Wednesday afternoon.
With her was Sara Myers, a woman diagnosed with Lou Gehrig's disease, who told reporters she’s suing New York state “to remove the legal barrier between my doctor and myself that prevents me from achieving a peaceful and dignified death, at the time and place of my choosing.”
The New York lawsuit comes two weeks after California lawmakers introduced legislation modeled after Oregon’s Death with Dignity Act, which allows doctors to prescribe life-ending drugs to any competent patient diagnosed with a terminal illness and given less than six months to live. The New York Assembly, meanwhile, also introduced a “death with dignity” act in January; the state Senate is expected to take up the issue at a later time.
More than a dozen states, including New York and California, have introduced legislation to permit physician aid-in-dying, according to the Death with Dignity National Center in Portland, Ore.
It’s a disturbing trend for the opponents of assisted suicide, especially for advocates of the disabled.
“There are more bills for legalizing assisted suicide than we have had in the past – a result of the media flurry surrounding Maynard,” says Diane Coleman, president and CEO of Not Dead Yet, a disability rights group based in Rochester, N.Y. “So for organizations who oppose assisted suicide … it means that a lot of public education is needed.”
This is the fourth time California has considered the issue: California voters rejected a proposal to allow doctors to administer a fatal dose of drugs to terminally-ill patients in 1992. The state legislature in 2005 and 2007 also rejected giving doctors the ability to prescribe lethal drugs to patients, who would administer the fatal dose themselves.
But the political landscape has shifted since then, and if California and New York begin to sanction the practice, experts say, the movement to allow aid-in-dying could quickly spread to other states.
A Gallup poll last year found that nearly seven in 10 Americans believed doctors should be allowed to "legally end a patient's life by some painless means." However, when Gallup asked whether doctors should be allowed to "assist the patient to commit suicide," only 58 percent of respondents concurred.
Three states currently sanction physician-assisted suicide. In addition to Oregon, which passed its law in 1997, Washington passed “death with dignity” legislation in 2008 and Vermont passed a law in 2012.
In 2009, Montana courts said that a physician accused of assisting a patient to die could use that patient’s consent as a legal defense – though it never sanctioned the practice. In 2014, a local New Mexico court legalized the practice in Bernalillo County – but the case is currently under appeal.
“People with terminal conditions are people with disabilities,” says Ms. Coleman, whose organization is scrambling to prepare a tool kit for advocates to be more effective in communicating with policy makers. “And there isn’t really all that bright of a line in most cases between someone who is and isn’t terminal. It’s all about a prediction that a doctor makes six months out – which is notoriously unreliable.”
And opponents cite Oregon’s required annual reports for its Death with Dignity Act, which list the most common reasons patients give for ending their lives. Instead of pain or the fear of future pain, the vast majority of those who choose to die – more than 90 percent each year – say they most fear losing their autonomy and not being able to engage in life’s enjoyable activities. And half say they are worried they will be a burden on family and friends.
There’s a financial incentive not to provide often-expensive care for the disabled and dying as well, other assisted-suicide opponents say, which can put subtle pressure those who have the option to end their lives.
“These are disability issues,” says Coleman, “and most importantly from our point of view, the autonomy, dignity, and feeling-like-a-burden issues, these are really about someone who needs help every day from another human being, and I myself, and many of us with significant disabilities, we have to rely on [others.]”